摘要
目的探讨心房黏液瘤的CT表现,以提高对该病的诊断水平。方法收集经手术病理证实为心房黏液瘤患者17例,均接受CT平扫及增强扫描,其中13例加做延迟期扫描。增强扫描使用回顾性心电门控螺旋扫描,对CT增强图像行多平面重建及曲面重建等后处理,主要观察肿物的形态、密度、部位及强化后的CT表现。结果 17例心房黏液瘤中左心房14例,右心房3例。CT平扫图像心房黏液瘤呈稍低密度影或等密度,平均CT值约为(21.39±10.63)HU,5例肿瘤内可见钙化。增强图像肿物边缘清晰,8例边缘光整,6例有分叶,3例表面呈菜花状,增强扫描动脉期无强化,延迟期10例轻度强化,7例无明显强化,增强后延迟期平均CT值约为(29.88±14.51)HU,但增强前后CT值均值无统计学差异(P>0.05)。多平面重建图像显示10例蒂较短而宽,2例肿物蒂较长,于舒张期脱入二尖瓣口,1例合并左侧髂动脉栓塞。结论 CT图像可清晰显示病变的形态、部位及密度;多平面重建有助于观察瘤蒂;增强后轻度强化或无强化对心房黏液瘤具有重要诊断价值。
Objective To explore the CT features of atrial myxoma and improve the diagnosis of the disease. Methods A total of 17 cases with atrial myxoma confmned by surgical operation were retrospectively studied. Plain and enhancement CT scan were performed in all 17 patients,and 13 cases additionally accepted delay scan. Retrospective ECG-gating technique was applied during enhanced scanning. The morphology,density,location and enhanced CT findings were observed by post-processing methods including multiple planar reconstruction （MPR） and curved planar reconstruction （CPR）. Results Of the 17 cases, 14 located in left atrium and 3 in right atrium. All tumors showed slightly hypo- or iso-density with average CT value of （21.39±10.63）HU on the non-enhanced CT images, and calcification were found in 5 tumors. The tumors were easily distinguished by enhanced CT images with clear edge （8 cases）,lobulated （6 cases） and cauliflower-like （3 cases）. No enhancement was observed in all the tumors at arterial phase, and 10 cases of slight enhancement were found at delay phase. The average CT value was （29.88±14.51）HU at delay phase. There was no statistical difference between before and after in- jection of contrast medium （P 〉 0.05 ）. Among the 17 cases, MPR images showed 10 tumors with pedicles, 2 tumors very mobile and partial- ly obstructing the tricuspid valve orifice during diastole, and 1 case coexisted with left iliac artery occlusion caused by detachment of atrial myxoma. Conclusion The CT examination can be applied for the density, location and morphology evaluation of the lesions. Especially, MPR post-processed technique is beneficial for observation of tumor pedicle. Slight enhancement or no enhancement has important diagnostic value for atrial myxoma.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2013年第3期217-220,共4页
Journal of China Medical University
基金
辽宁省教育厅高校科研计划(20060971)
